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Local variability in long-term care services: local autonomy, exogenous influences and policy spillovers

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  • Fernández, José-Luis
  • Forder, Julien

Abstract

In many countries, public responsibility over the funding and provision of long-term care services is held at the local level. In such systems, long-term care provision is often characterised by significant local variability. Using a panel dataset of local authorities over the period 2002 to 2012, the paper investigates the underlying causes of variation in gross social care expenditure for older people in England. The analysis distinguishes between factors outside the direct control of policy makers, local preferences, and local policy spillovers. The results indicate that local demand and supply factors, and to a much lesser extent local political preferences and spatial policy spillovers, explain a large majority of the observed variation in expenditure.

Suggested Citation

  • Fernández, José-Luis & Forder, Julien, 2015. "Local variability in long-term care services: local autonomy, exogenous influences and policy spillovers," LSE Research Online Documents on Economics 60378, London School of Economics and Political Science, LSE Library.
  • Handle: RePEc:ehl:lserod:60378
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    File URL: http://eprints.lse.ac.uk/60378/
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    1. Kevin Morgan, 2001. "The New Territorial Politics: Rivalry and Justice in Post-devolution Britain," Regional Studies, Taylor & Francis Journals, vol. 35(4), pages 343-348.
    2. Revelli, Federico, 2006. "Performance rating and yardstick competition in social service provision," Journal of Public Economics, Elsevier, vol. 90(3), pages 459-475, February.
    3. Ekaterini Panopoulou & Theologos Pantelidis, 2013. "Cross‐State Disparities In Us Health Care Expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 22(4), pages 451-465, April.
    4. Federico Belotti & Gordon Hughes & Andrea Piano Mortari, 2013. "xsmle: A Stata command for spatial panel-data models estimation," German Stata Users' Group Meetings 2013 09, Stata Users Group.
    5. Moscone, Francesco & Knapp, Martin & Tosetti, Elisa, 2007. "Mental health expenditure in England: A spatial panel approach," Journal of Health Economics, Elsevier, vol. 26(4), pages 842-864, July.
    6. Hashem Pesaran, M. & Yamagata, Takashi, 2008. "Testing slope homogeneity in large panels," Journal of Econometrics, Elsevier, vol. 142(1), pages 50-93, January.
    7. Van Houtven, Courtney Harold & Norton, Edward C., 2004. "Informal care and health care use of older adults," Journal of Health Economics, Elsevier, vol. 23(6), pages 1159-1180, November.
    8. Forder, Julien & Allan, Stephen, 2014. "The impact of competition on quality and prices in the English care homes market," Journal of Health Economics, Elsevier, vol. 34(C), pages 73-83.
    9. Anne Case, 1993. "Interstate tax competition after TRA86," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 12(1), pages 136-148.
    10. Morris, Stephen & Sutton, Matthew & Gravelle, Hugh, 2005. "Inequity and inequality in the use of health care in England: an empirical investigation," Social Science & Medicine, Elsevier, vol. 60(6), pages 1251-1266, March.
    11. Sinn, Hans-Werner, . "The New Systems Competition: YRJÖ Jahnsson Lectures," Monographs in Economics, University of Munich, Department of Economics, number 19614, November.
    12. Thomas Kopetsch & Hendrik Schmitz, 2014. "Regional Variation In The Utilisation Of Ambulatory Services In Germany," Health Economics, John Wiley & Sons, Ltd., vol. 23(12), pages 1481-1492, December.
    13. Anselin, Luc, 2002. "Under the hood : Issues in the specification and interpretation of spatial regression models," Agricultural Economics, Blackwell, vol. 27(3), pages 247-267, November.
    14. Andrew J. Rettenmaier & Zijun Wang, 2012. "Regional variations in medical spending and utilization: a longitudinal analysis of US Medicare population," Health Economics, John Wiley & Sons, Ltd., vol. 21(2), pages 67-82, February.
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    Cited by:

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    2. Castro, Marcelo Araújo & Mattos, Enlinson & Patriota, Fernanda, 2016. "Spatial spillovers and political coordination in public health provision," Textos para discussão 417, FGV EESP - Escola de Economia de São Paulo, Fundação Getulio Vargas (Brazil).
    3. Jeremy McCauley, 2020. "The Role of Information in Explaining the Lack of Welfare-Induced Migration," Bristol Economics Discussion Papers 20/729, School of Economics, University of Bristol, UK.
    4. Maja Matanic Vautmans & Marijana Oreb & Sasa Drezgic, 2023. "Socioeconomic inequality in the use of long-term care for the elderly in Europe," Public Sector Economics, Institute of Public Finance, vol. 47(2), pages 149-176.
    5. Marenzi, Anna & Rizzi, Dino & Zanette, Michele & Zantomio, Francesca, 2023. "Regional institutional quality and territorial equity in LTC provision," The Journal of the Economics of Ageing, Elsevier, vol. 26(C).
    6. Waitzberg, Ruth & Schmidt, Andrea E. & Blümel, Miriam & Penneau, Anne & Farmakas, Antonis & Ljungvall, Åsa & Barbabella, Francesco & Augusto, Gonçalo Figueiredo & Marchildon, Gregory P. & Saunes, Ingr, 2020. "Mapping variability in allocation of Long-Term Care funds across payer agencies in OECD countries," Health Policy, Elsevier, vol. 124(5), pages 491-500.
    7. Stefania Ilinca & Ricardo Rodrigues & Andrea E. Schmidt, 2017. "Fairness and Eligibility to Long-Term Care: An Analysis of the Factors Driving Inequality and Inequity in the Use of Home Care for Older Europeans," IJERPH, MDPI, vol. 14(10), pages 1-15, October.
    8. Marenzi, A.; & Rizzi, D.; & Zanette, M.; & Zantomio, F.;, 2022. "Regional Institutional Quality and Territorial Equity in LTC Provision," Health, Econometrics and Data Group (HEDG) Working Papers 22/27, HEDG, c/o Department of Economics, University of York.
    9. Shun-ichiro Bessho & Yoko Ibuka, 2016. "Vaccination policy of Japanese municipalities," Keio-IES Discussion Paper Series 2016-004, Institute for Economics Studies, Keio University.
    10. Shun‐ichiro Bessho & Yoko Ibuka, 2019. "Interdependency in vaccination policies among Japanese municipalities," Health Economics, John Wiley & Sons, Ltd., vol. 28(2), pages 299-310, February.
    11. Walsh, Brendan & Wren, Maev-Ann & Smith, Samantha & Lyons, Seán & Eighan, James & Morgenroth, Edgar, 2019. "An analysis of the effects on Irish hospital care of the supply of care inside and outside the hospital," Research Series, Economic and Social Research Institute (ESRI), number RS91.

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    More about this item

    Keywords

    long-term care; spatial; variability; spillovers;
    All these keywords.

    JEL classification:

    • J50 - Labor and Demographic Economics - - Labor-Management Relations, Trade Unions, and Collective Bargaining - - - General

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